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Search Results: 1 - 10 of 3744 matches for " Bj?rn Moum "
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Epidemiology and clinical course of Crohn's disease: Results from observational studies
?istein Hovde,Bjrn A Moum
World Journal of Gastroenterology , 2012, DOI: 10.3748/wjg.v18.i15.1723
Abstract: The authors review the clinical outcome in patients with Crohn’s disease (CD) based on studies describing the natural course of the disease. Population-based studies have demonstrated that the incidence rates and prevalence rates for CD have increased since the mid-1970s. The authors search for English language articles from 1980 until 2011. Geographical variations, incidence, prevalence, smoking habits, sex, mortality and medications are investigated. An increasing incidence and prevalence of CD have been found over the last three decades. The disease seems to be most common in northern Europe and North America, but is probably increasing also in Asia and Africa. Smoking is associated with an increased risk of developing CD. Age < 40 at diagnosis, penetrating/stricturing complications, need for systemic steroids, and disease location in terminal ileum are factors associated with higher relapse rates. A slight predominance of women diagnosed with CD has been found. Ileocecal resection is the most commonly performed surgical procedure, and within the first five years after the diagnosis about one third of the patients have had intestinal surgery. Smoking is associated with a worse clinical course and with increased risk of flare-ups. In most studies the overall mortality is comparable to the background population. To date, the most effective treatment options in acute flares are glucocorticosteroids and tumor necrosis factor (TNF)-α- blockers. Azathioprine/methotrexate and TNF-α-blockers are effective in maintaining remission.
Worries and Concerns among Inflammatory Bowel Disease Patients Followed Prospectively over One Year
Lars-Petter Jelsness-J?rgensen,Bjrn Moum,Tomm Bernklev
Gastroenterology Research and Practice , 2011, DOI: 10.1155/2011/492034
Abstract: Disease-related worries are frequently reported in inflammatory bowel disease (IBD), but longitudinal assessments of these worries are scarce. In the present study, patients completed the rating form of IBD patient concerns (RFIPC) at three occasions during one year. One-way analysis of variance (ANO VA), t-tests, bivariate correlation, and linear regression analyses were used to analyse data. The validity and reliability of the Norwegian RFIPC was tested. A total of 140 patients were included (V1), ulcerative colitis (UC) n = 92, Crohn's disease (CD) n = 48, mean age 46.9 and 40.0-year old, respectively. The highest rated worries included having an ostomy bag, loss of bowel control, and reduced energy levels. Symptoms were positively associated with more worries. A pattern of IBD-related worries was consistent over a period of one year. Worries about undergoing surgery or having an ostomy bag seemed to persist even when symptoms improved. The Norwegian RFIPC is valid and reliable. 1. Introduction In inflammatory bowel disease (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), the measurement of health-related quality of life (HRQOL) has become important, both as a primary and secondary endpoint [1–4]. In IBD, the decrease in HRQOL scores is well documented in a vast amount of studies [2–4]. Subjective health measurements in patient research may reveal important issues for the patient, but not apparent for the healthcare worker [1]. In accordance with observations made in clinical practice and with intention to help clinicians quantify information about IBD- related worries, Drossman et al. [5] developed the rating form of IBD patient concerns (RFIPC). Various studies have made use of the RFIPC in clinical trials [5–10]. These studies do, however, have a cross-sectional design, which only provide a snapshot at a given point of time. Since worries most often is future directed, they may potentially change in time and space. Our knowledge of IBD-related worries in a longitudinal perspective is limited. Only one study addresses these issues prospectively in CD, but not in UC [11]. Results of a longitudinal assessment of IBD-related worries may facilitate patient-physician communication and consequently be clinically impactful [1]. Different studies have found the RFIPC to be valid and reliable [5–10]. However, the RFIPC needs to be translated and tested psychometrically in the Norwegian language to overcome conceptual, semantic, and linguistic differences across cultures and languages [1, 12]. The primary aim of this study was to assess
Sense of Coherence in Patients with Inflammatory Bowel Disease
Randi Opheim,May Solveig Fagermoen,Lars-Petter Jelsness-J?rgensen,Tomm Bernklev,Bjrn Moum
Gastroenterology Research and Practice , 2014, DOI: 10.1155/2014/989038
Abstract: Background and Aim. Sense of coherence (SOC) is a health-promoting concept reflecting a person’s view of life and response to stressful situations and may be of importance in coping with chronic illness. The aim of this study was to explore associations between SOC and sociodemographic, disease-related, and personal characteristics in a sample of patients with inflammatory bowel disease (IBD). Methods. Measures included sociodemographic and disease-related data, the Sense of Coherence Scale, General Self-Efficacy Scale (GSE), and Fatigue Severity Scale (FSS-5). Results. In total, 428 IBD patients had evaluable questionnaires (response rate 93%). The overall mean SOC total score was 66.25 (SD 11.47) and with no statistically significant difference between patients with ulcerative colitis (UC) and patients with Crohn’s disease (CD). In the multivariate analyses, higher GSE scores were significantly associated with higher SOC scores and higher FSS-5 scores were significantly associated with lower SOC scores in both UC and CD. Conclusion. GSE and FSS-5 contributed more to the variance in SOC than sociodemographic and disease-related variables. Longitudinal studies are warranted to investigate the value of SOC as a predictor of disability, medication adherence, coping behavior, and health-related quality of life. 1. Introduction The inflammatory bowel diseases (IBD), Crohn’s disease (CD), and ulcerative colitis (UC) are chronic inflammatory disorders of the gastrointestinal tract of unknown etiology. The course of disease is characterized by periods of symptom flares and periods with quiescent disease. Common symptoms are diarrhea, bloody stools, fever, fatigue, and abdominal pain [1–3]. As with many chronic diseases, IBD patients’ quality of life and psychosocial function have been shown to be influenced by their disease [4–8]. Further, patients diagnosed with IBD at a young age and with a severe disease course have an increased risk for work disability [9]. Coping with a chronic illness such as IBD involves complex cognitive, physical, emotional, psychological, and behavioral processes [5]. Patients must be able to manage complex medication regimens, find meaning in and adapt to changeable life conditions, and deal with emotions associated with the fact that the disease is not curable. The unpredictable disease course also poses challenges for the patients’ daily life as well their life in general [10]. Given the complexity of living with a chronic illness, personal resources may be of importance for patients’ well-being, quality of life, and ability to
Application of Pedagogical Perspectives in the Teaching and Training of New Cataract Surgeons—A Literature-Based Essay  [PDF]
Bjrn Johansson
Open Journal of Ophthalmology (OJOph) , 2013, DOI: 10.4236/ojoph.2013.33015

Cataract is the most common cause of visual impairment that can be effectively treated by surgery and cataract surgery is the most commonly performed surgical procedure in the world. With modern cataract operation techniques, patients expect excellent results. Teaching and training of new surgeons involve both pedagogical and ethical challenges for teachers and trainees, and also may pose a potential risk to patients. This literature-based essay aims to describe how behavioristic, cognitive and conceptual learning perspectives can be recognized during the trainee surgeons progress. It also describes how teacher-pupil relationships may vary during the training process. Finally it presents the concept of situational tutorship, where the teacher adapts to the stages that the trainee passes through with increasing experience. Teaching and trainee surgeons who are aware of pedagogical concepts such as teacher-pupil relationships and tutoring strategies may use this knowledge to optimize the learning process. Further research is needed to clarify how using this knowledge may affect the training of new cataract surgeons.

Reviewing the Learning Process through Creative Puzzle Solving  [PDF]
Bjrn Petter Jelle
Creative Education (CE) , 2017, DOI: 10.4236/ce.2017.813137
Abstract: Human beings are at a continuous learning process at various levels and with different motivations during their whole lifetime. Puzzle solving may beneficially be applied to increase the motivation, enhance the mastering apprehension, promote the creative processes, expand the ability to engage and solve miscellaneous challenges from various viewpoints, and hence lead to an improved learning process and problem solving capability. That is, the application of puzzles may lead to better learning and increased knowledge in general, stimulating the reasoning process and the apprehension of the need for both creativity and hard work. Thus, teachers of both students and teachers may find it beneficial to utilize the art of puzzle solving. Typically, the puzzles are very suitable for and mostly used in mathematics and natural science classes. Nevertheless, the puzzles are in general also applicable for any type of class. The aim of this study is to examine and discuss the learning process through applying creative puzzle solving as a teaching tool. These aspects are illustrated through a review of several selected puzzle examples.
Limited Focus on the Use of Health Care by Elderly Migrants—A Literature Review  [PDF]
Katarina Hjelm, Bjrn Albin
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.46049

Our premise for this literature review is the global demographic change caused by the world’s population living longer and becoming older, and extensive international migration leading to multicultural societies. Increasing age leads to health problems, often long-term or chronic, requiring investments in health care. Worse health and dissimilarities in pattern of morbidity/ mortality have been found in foreign-compared to Swedish-born persons, so it is reasonable to assume that this affects use of health care. The exploratory review focuses on elderly migrants’ (>65 years) use of healthcare. The databases Pub Med, EBSCO, CINAHL and ERIC were searched in 2000-2013. A limited number of studies were found; few had a comparative approach, most were from the USA, and focused on migrants from the former Soviet Union or countries in South-East Asia. A range of factors were identified that influence patterns of health care use: language fluency, ability to communicate, self-reported health status, prevalence of chronic disease, physical distance from care provision, availability of transport to reach care, cost of care, the health insurance system, cultural norms and values regarding different forms of care, level of education, and length of residence in the host country. Most studies treated health care from a general perspective and collected data from community and hospital settings, without analysing usage separately. Some studies indicated elderly migrants making use of health care less than other groups but the pattern is not unambiguous: other studies show that there is an overuse of health care. It is therefore difficult to show any particular pattern, or possible differences in use, regarding community versus in-patient care. Studies focusing on migrants’ actual use of health care are few and further research is needed, especially because elderly people form the largest group of users of health care and will be even larger in the future.

Cement Bonded Particle Boards with Different Types of Natural Fibres—Using Carbon Dioxide Injection for Increased Initial Bonding  [PDF]
Bjrn Marteinsson, Edgar Gudmundsson
Open Journal of Composite Materials (OJCM) , 2018, DOI: 10.4236/ojcm.2018.81003
Abstract: The effect of CO2 injection on initial strength increase and hardening of cement-fibre mix in a cement bonded particle board (CBPB) production was evaluated. Different cement contents, formation pressure and types of fibres were considered. The initial strength increase with CO2 injection is so much faster than this caused by conventional hydration that the produced samples do not need additional curing before they can be stored. Similar strength and stiffness values as in conventional products on the market are gained with lower cement content for similar types of fibres. Visual inspection of board surfaces aged for 13 years in a harsh exterior environment as well as comparison of strength and stiffness values for these boards when new and after ageing, gives a very satisfying result. The combined effect of the above discussed gains results in markedly increased productivity at lower cost and lower environmental impacts than is possible in traditional CBPB production.
Concealed Integrity Monitoring for Wireless Sensor Networks  [PDF]
Bjrn Stelte, Thomas Bühring
Wireless Sensor Network (WSN) , 2011, DOI: 10.4236/wsn.2011.31002
Abstract: Nowadays, sensor networks are widely installed around the world. Typical sensors provide data for healthcare, energy management, environmental monitoring, etc. In the future sensors will become a part of critical infrastructures. In such a scenario the network operator has to monitor the integrity of the network devices, otherwise the trustworthiness of the whole system is questionable. The problem is that every integrity protocol needs a secure channel between the devices. Therefore, we will introduce a covert channel for hidden transportation of integrity monitoring messages. The covert channel enables us to hide integrity check messages embedded into regular traffic without giving potential attackers a hint on the used integrity protocol.
Diversity in Family Structure—Diversity in Communication between Family Members?  [PDF]
Piia M. Bjrn, Minna Kytt?l?
Psychology (PSYCH) , 2013, DOI: 10.4236/psych.2013.43A035

This study aims at investigating the parent-adolescent communication of Finnish families from a multi informant perspective. Thirteen- and fourteen-year-old adolescents (n = 171) and their parents were asked to complete a questionnaire examining positive and problematic communication between the two parties. Information about their family structure was collected. The results indicated an interrelationship between parental and adolescent assessments, particularly regarding negative aspects of communication. The boys assessed their communication with parents as more positive than did the girls. The results showed that the mothers still are the synchronizing hearts of communication in modern families, whereas the fathers’ roles in family communication were more modest suggesting that the stereotypical roles in Finnish families persist even today.

Spatial Competition between Health Care Providers: Effects of Standardization  [PDF]
Bjrn A. Kuchinke, Jürgen Zerth
Theoretical Economics Letters (TEL) , 2015, DOI: 10.4236/tel.2015.53043
Abstract: In the international health care literature the impacts of competition in health care markets are discussed widely. But aspects of standardization in regional health care markets with no price competition received comparatively little attention. We use a typical Hotelling framework to analyze a regional health care market with two health care providers competing in (vertical) quality after the scope of medical treatment has been set (horizontal quality). We conclude that in the basic model both health care providers will use vertical quality to separate from each other. In the next step we introduce a standard in vertical quality of which one health care providerthe standard profiteer—could better cope with. In the standardization case a more homogeneous supply can be expected and there is a higher possibility that the standard follower has to leave the regional health care market. Therefore standardization of health care quality could strengthen monopolistic tendencies.
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